Sensorineural Hearing Loss as a First Presentation of Multiple Myeloma: A Successful Management with Therapeutic Plasma Exchange

Morteza  Daraei; Ahmad  Khajeh-Mehrizi; Behrooz  Amirzargar; Fereshteh  Ameli; Fahimeh  Zeinalkhani

doi:10.18502/crcp.v9i3.17239

Morteza Daraei Imam Khomeini Hospital Complex, Department of Internal Medicine, Tehran University of Medical Sciences Tehran, Iran.
Ahmad Khajeh-Mehrizi Department of Hematology and Medical Oncology, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
Behrooz Amirzargar Otorhinolaryngology Research Center, Department of Otorhinolaryngology-Head and Neck Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Fereshteh Ameli Department of Pathology, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
Fahimeh Zeinalkhani Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/crcp.v9i3.17239

Keywords: Sensorineural hearing loss; Viscosity; Multiple myeloma; Plasma exchange

Abstract

Sudden sensorineural hearing loss (SSNHL) as the initial manifestation of multiple myeloma (MM) is rare. We present a 45-year-old woman with hyperviscosity syndrome (serum viscosity of 10.2 cP) from MM who presented with hearing disturbance that responded dramatically to plasma exchange with saline and intratympanic steroid treatment. Serum protein electrophoresis confirmed the presence of a monoclonal band, and bone marrow biopsy showed a hypercellular marrow with 90% plasma cells, which demonstrated lambda monoclonal restriction